The American journal of sports medicine
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Chronic exertional compartment syndrome (CECS) is a cause of leg pain in running athletes and is treated with fasciotomy after failure of nonoperative management. CECS is being seen with increased frequency in younger patients. The demographics and outcomes of fasciotomy for CECS in pediatric patients, including risk factors for treatment failure, have not been described. ⋯ CECS in pediatric patients most commonly occurs in adolescent females participating in running sports. Fasciotomy results in a 79.5% return-to-sports rate. Recurrence occurs in 18.8% of patients, more commonly in patients undergoing anterior and lateral release only.
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Low-intensity pulsed ultrasound stimulation (LIPUS) has been proven to be a beneficial biophysical therapy for tendon-bone (T-B) healing. However, the optimal time to initiate LIPUS treatment has not been determined yet. LIPUS initiated at different stages of the inflammatory phase may profoundly affect T-B healing. ⋯ The findings of the study may help optimize the initiation timing of LIPUS for T-B healing.
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Hip arthroscopy for young patients with femoroacetabular impingement (FAI) has been successful, but the efficacy of hip arthroscopy in older patients is not clearly defined. ⋯ Although younger patients had superior HOS outcomes reported at 2 years compared with older patients after hip arthroscopy for FAI, both groups had significant improvement compared with their baseline. These data suggest that carefully selected patients 55 years and older without radiographic arthritis may benefit from hip arthroscopy.
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Symptomatic labral tears are common in patients with acetabular dysplasia; however, optimal treatment of the labrum remains controversial. ⋯ Patients undergoing combined arthroscopic labral refixation and PAO were older and had increased acetabular anteversion versus patients undergoing PAO alone. Combined arthroscopic labral refixation and PAO was safe, did not affect PAO operative time or radiographic correction achievement, and may benefit clinical outcomes in this patient subset.
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Randomized Controlled Trial Comparative Study
Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction: Midterm Clinical Outcomes.
Most studies on grafts for anterior cruciate ligament (ACL) reconstruction (ACLR) have been of autografts or nonirradiated allografts with a single-bundle (SB) technique. Outcome reports evaluating anatomic double-bundle (DB) ACLR with a hamstring tendon autograft versus irradiated allograft are rare. ⋯ There were no significant differences in postoperative activity levels and functional outcomes between the Auto and Ir-Allo groups. However, a significant increase in anterior and rotational laxity in the Ir-Allo group was found according to evaluations. We do not advocate an irradiated hamstring tendon allograft for DB ACLR.